Pandemic Trends in Student Alcohol Misuse
Host: Hello, and welcome to Prevention and Protection, United Educators’ Risk Management podcast. Today’s guest is Dr. Pietro Sasso, faculty member at Stephen F. Austin State University and faculty research fellow at the Piazza Center for Fraternity and Sorority Research and Reform at Penn State University.
Dr. Sasso’s research and publications focus on how students’ identity affects the college experience, student success, and today’s topic, student alcohol use. Dr. Sasso is joining Justin Kollinger, Risk Management Consultant at United Educators, to discuss alcohol misuse and abuse patterns among students, how those patterns may change for at-risk students as we emerge from the pandemic, and how risk managers can support their colleagues in student affairs.
Before we begin, a quick reminder that you can find other United Educators (UE) podcasts and general risk management resources, along with resources related to COVID-19, on our website, edurisksolutions.org.
All of UE’s podcasts are also available on Apple Music.
Kollinger: Welcome, Dr. Sasso. Happy to have you and your years of experience studying student alcohol use patterns. We’re at an interesting time. Due to COVID, students haven’t been able to socialize like they have in the past, leading to a change in alcohol use habits. This change in habits could have implications for how we think about mitigating risks from student alcohol misuse and abuse.
I think many of us think of student alcohol use as something unchanging, and we assume that our experiences as students inform how students drink today. I think that’s worth debunking. Can you briefly tell the story of how students’ alcohol use patterns have changed in the last few decades?
Sasso: Yeah. To start, I think there’s a separation that I wanted to note that’s really important. So there’s two kind of fundamental concepts that shape these patterns. The first construct is this idea of alcohol misuse vs. alcohol abuse. So alcohol misuse is, what we think of as students trying to party, students’ binge drinking, what we also might call heavy episodic drinking, which is a more consistent form of binge drinking. That’s misuse. It’s short-term, episodic, event-based drinking, or as rites of passage, whereas alcohol abuse is the more sustained, consistent form of alcohol consumption.
So I think what I’m trying to say is, there’re two very distinct patterns. We’ve seen a sustained level of student alcohol abuse. About one in 10 students will engage in sustained alcohol abuse during their undergraduate experience. And then there’s this other group that tends to ebb and flow. It’s this 40% of students that tends to engage in alcohol misuse. And so, this is the group that’s really changed over the last 30 years.
Let me kind of walk you through what this looks like by decade. There was a substantial shift in drinking. So in the late ’90s, we saw this dramatic shift as millennials started to come to campus in the 1990s. There was a huge uptick in how students drink. This started this trend of what students call, you pregame, and then you drink. And just a lot more increased alcohol consumption is what generally happened.
And then probably between 2000 and 2010, we saw this upward trend of drinking, where we had a lot more injuries and fatalities and other tertiary health behaviors around alcohol. And so, what shifted in the 2000s, specifically, was what the research calls event-specific drinking. Examples of these [are] you tailgate at sporting events, you pregame for other parties, and then you show up drunk. And you continue to drink while you are, and you become more intoxicated.
A lot of the Big 12 schools have things they call day-longs, where you drink all day on like a Saturday or Sunday. And so, that event-specific drinking is what changed a lot. And the other thing that really changed in the early 2000s, maybe to 2010, was a focus on large social parties, or large social gatherings, house parties. And so, the popular culture captured this party phase in the early 2000s.
And then as millennials graduated out of undergrad by 2012, 2016, and we saw the shift to Gen Z, we’ve seen a decrease in overall alcohol consumption by students. However, the rates of binge drinking are still high. So what that means is that students’ overall consumption is down. So they are drinking less frequently compared to their previous student generations. However, when they do drink, they drink just as much as the previous cohorts of students, or cycles of students.
So injuries and fatalities, I think the data suggests, seems to be consistent. I think the other challenge that’s cycling back around, is the ways in which Gen Z students tend to mix alcohol with other substances. And that can cause other issues of self-harm, and other tertiary health impacts. I think what one can summarize is, things come back around. And so, what we’re predicting and what we’re starting to see is that return of the party culture.
We’re seeing it creeping in, especially the last few semesters. COVID has challenged that. I think with a return to normalcy over time, I wonder to what extent we’ll see a return to that late ’90s party culture.
Kollinger: And I should clarify here as we’re recording this in September 2021, a lot of students are back on campus, but social life has not necessarily fully recovered. I’m hearing more and more concerns of a post-pandemic return to the quote unquote “Roaring 20s.” And in short, the assumption is that students will not just return to their prior drinking patterns but start to exceed them in those cultural expectations of what partying might look like.
And as risk managers, we see alcohol misuse as a root cause to many student safety incidents, which you’ve started to touch on. I’m going to go through some data here. First from the National Institute on Alcohol Abuse and Alcoholism. Each year, they report that a little less than 700,000 students are assaulted by another student who was drinking, which is inclusive of just about 100,000 sexual assaults.
And perhaps more tragically, there are over 1,500 college student fatalities that are alcohol-related each year. From our perspective at UE, we see these consequences in our claims experience. More than half of deaths arising from fraternity and sorority activities involved alcohol. And more than half of student-perpetrated sexual assault claims involved alcohol.
Even in study abroad, even in instances off campus, one-third of our claims involved alcohol. With that in mind, you left a story on student alcohol use patterns at the start of the pandemic. Can you pick up with how alcohol use appears to be changing during the pandemic?
Sasso: I do a lot of research around student life. And so, I do a lot of qualitative data. And so, students are storytelling, and we find themes across what those narratives and storytelling is, using the voice of our students, as well as I do survey data. And I think what’s the most compelling about these narratives and stories that students are telling us, that big-time party culture with open parties, and in fraternity houses or in student off-campus apartments or student neighborhoods at like a land-grant university, those are still substantial parts of the undergraduate student experience in terms of student party culture.
What has shifted, though, for Generation Z in particular, students now in the contemporary context and frame, is that they’re drinking in smaller groups. And their drinking is more sophisticated. Students know more about alcohol now than they did. And so, I think we’re seeing a couple trends.
I think the first thing is that student expectancy around alcohol is higher. They have increased the expectations to drink, and they pre-contemplate when they want to become intoxicated. So it’s becoming more of a pre-contemplative behavior for students. And I have research that I did, gosh, back in 2012 to ’16, where that trend was starting. And so, I think that that continues now.
I think the next trend that we’re seeing again, is students in smaller groups, not as large open parties, it’s more smaller groups of friends in apartments or residence halls or townhouses. And so, students tend to drink. The other trend, I think, that’s significantly changed with COVID and with students now, is, in particular, students are coming to college with the expectation that they want to drink.
There used to be this data that suggested that 20% of students binge drink. And this other like 60% of students were sometimes drinkers, and that last 20% abstained. That 60%, what’s changed is that they’re coming to college with the expectation that they want to drink. These are not just sometimes drinkers, but they have previous experiences with alcohol coming from high school.
For the traditional-age undergraduate students, they come to college as a commuter, or as a residential student having drank in high school to some extent. They’ve had substantial experiences with alcohol, where they drank in high school, at least during their junior and senior years. So that’s what’s changed too. And so, that shifts all of the expectations that students bring into college with them. That expectancy, that pre-contemplation to drink, and those established high school drinking patterns, all sort of compounds this need, or the fascination with wanting to drink alcohol in college.
Kollinger: You’ve touched on how drinking has changed over the decades, and what it’s been like recently. How do you think drinking culture will change going forward in the era of delta COVID and beyond?
Sasso: I think as universities navigate these waves of the pandemic with all the variants, and eventually we return to some sense of normalcy, I think what we’re going to continue to see is students drinking in smaller groups. There’s two competing theories. There’s this idea of anonymity – that when students are nameless and faceless in a larger crowd, college men feel more comfortable drinking alcohol. Whereas women in smaller spaces feel more comfortable drinking alcohol.
So I think there is a gender divide in the ways in which men and women consume alcohol and where they feel most comfortable doing that. I think this has implications for students’ safety around sexual assault, around sexual violence, around other tertiary health outcomes, around student injury, things like that. So I think what we’re going to see for at-risk populations is the continued trend of heavy student drinking. That seems to be very consistent among that 20% ─ really hasn’t changed much since the late ’90s.
But that 60% that is more open to casual or infrequent drinking that does binge drink, certainly their expectations and other pre-college behaviors have changed. But I think when we delve down a little deeper and look at the nuances, it’s a story of gender and the ways in which the spaces that men and women undergraduate students feel more comfortable. It sort of makes it like this prohibition type of environment like we’re seeing now.
Kollinger: Do drinking habits change across the students’ time in college? And if they do, how do those habits evolve over that period?
Sasso: There tends to be this larger trend: Undergraduate drinking will increase during your freshman year, drop during your sophomore year, sort of almost flatline your junior year. But the minute you turn 21, [which] for most students tends to be at some point in time during their third year, it spikes back up. So usually, by the end of your [junior] year, your drinking picks back up like it did your freshman year, but the space has changed, right? You don’t drink on campus, not at house parties, not at apartment parties. You tend to pregame less and you tend to go to bars and other spaces because you’re a legal age to drink.
It tends to decline as you graduate. And so, I think what’s somewhat unique about American higher education is we have this idea of the four-year degree but most students actually graduate in four and a half years. And so, you add on this extra semester for a lot of students. And so, that extra semester, I think is fascinating. And so, some students tend to pick up how much they will drink in their senior year, rather than have it decline.
COVID challenges all of these presuppositions we have. And so, all these patterns are really fascinating, they’re compelling. But I think to those hearing the podcast, and listening, I think COVID is going to accelerate them. So when students come back, the intensity, magnitude, and impact of them will be greater. There’ll be more students doing this. And these patterns will be more widespread across that 60%.
Kollinger: I'd like to dig into that a little more deeply. Not only do we have a lot of first-year students come into campus for the first time following the pandemic, we also have a lot of second-year students coming to campus for the first time. And so, it aligns with what you were talking about in saying that, there could be an increase in intensity, in depth of alcohol consumption.
And I’m just starting to think through the implications for some of these other at-risk populations. I’m wondering if you can run through a couple of the at-risk populations that might be on your mind and how the drinking expectations that they bring to campus may change as a result of COVID-19.
Sasso: Oh yeah. That’s a really good point. I wrote about this a little bit in an article I wrote for Inside Higher Ed, where we sort of predicted some trends around student alcohol use. And one of the ideas we came up with was this idea of what we call social compression of student life. If you think about the idea of compression is that, if you compress something, eventually that pressure has to release.
And so, you have basically two cycles of incoming cohorts of freshmen that have had a non-traditional undergraduate experience. And with those student expectations now, they want the undergraduate experience that has largely tethered to alcohol use. You have freshmen now who live on campus, who are first-year students, who are having this sort of hybrid experience. But then the freshmen who started last year, who are now in their second year, did not have a traditional undergraduate experience.
And then you had freshmen from the 20-year, who had their freshman year disrupted. Those are now students in their third year. You have three cycles of students going back to 2019 who have not had a traditional undergraduate experience. And so, the extent to which those students want to embody, and want to take advantage of that, I think is something that we’re going to see.
I think now with the students that had their freshmen COVID year disrupted, those students are turning 21. And so, they’re going to have a lot of fun in their junior year. So they’re going to go a lot to bars. I think these now sophomores or second years, as well as these first-year students, are going to pregame more, and they are going to drink in smaller groups. What we’re going to see is increased drinking occurring in smaller groups. I think that is the overall trend.
And then I think this will all compound these first-year, second-year, and third-year students by academic level. It’ll sort of all converge as these juniors become seniors, and all these students move up. And then you’ll have a new cohort starting fall of 2022. And you’ll have four years of students who really want to have a lot of fun in college. And so, I think in our fall ’22 year or our spring ’22 year is where we’ll really start to see the impact of this kind of late ’90s era, binge drinking and party culture.
Kollinger: One of the other things that’s on my mind here is that student alcohol use often is done to fit a need. And one of those needs that students often are filling is a desire to fit in, particularly when it comes to a culture of drinking. I spoke with a substance abuse coordinator who talked about reduced social skills coming out of the pandemic. The relative seclusion of students from their social lives could have led to weaker social skills. Is that something that is on your radar, particularly how alcohol might help students overcome that lack of social readiness that they might have otherwise been burning up?
Sasso: A lot of theorists have posited the personality characteristics of Gen Z and what their profile is. I don’t know as a researcher that that has any impact. What the pandemic does is it impacts student mental health. Counseling centers, anecdotally, have been reporting that they have seen increased student drinking because students feel isolated.
And so, students have been engaging in alcohol not misuse, but abuse, as a coping strategy, as an unhealthy coping strategy, to navigate social isolation. I think that that’s one nuanced pattern of alcohol misuse, abuse that we’re seeing. The other trend is that yes, first-year students, sophomores, students in general want to fit in.
I think this is not going to change honestly. There’s research that suggests that students with established pre-college drinking behaviors who were heavy drinkers in their senior year self-select into environments that are heavy drinking environments.
Kollinger: That’s their senior year of high school, correct?
Sasso: Yes. For example, if I’m on the lacrosse team and my lacrosse team in high school drank a lot my senior year, I’m going to self-select at a university I know that has a party culture. And I might join a fraternity or join an all-male group of some kind or pick roommates [who] also like to drink a lot too. And so, when you have these all-male hegemonies or cultures that drink a lot, what tends to happen is that other men, specifically first-year students, tend to conform to the alcohol consumption patterns of the older college men.
So if I’m a junior and I drink a lot, and all my friends do, and I’m on a sports team, and then I’m a freshman starting on the lacrosse team or the football team, track team, whatever, I will be more likely to follow their patterns. And so, it’s a game of follow the leader, is what the research says. And this is somewhat nuanced in women too. Increasingly college women are increasing how much they drink. And this is something that I’ve been working on some specific research around the ways in which women use alcohol, particularly in sororities.
Women are starting to construct their own nuanced patterns of drinking. It was assumed that women didn’t drink as heavily as men do, but there is a distinct pattern that the research suggests is emerging – that more women are increasingly drinking at levels that college men are. And so, I think that that’s something that is changing. This is particularly problematic, right? This might answer your question.
When men drink, it’s about gender performance. Men drink to compete and to prove how masculine they are. That’s a nuanced form of conformity for men.
For women, women self-report that they drink to fit in. Women also tend to pregame more than men do. And so, if say this is COVID, right, and there’s three or four women [who] are juniors, and they’re in a sorority, and they’re friends with a new member or just a group of women like RAs or student leaders, and they’re upperclassmen and you’re a new student leader, what’s going to happen is that that female identified student is more likely to conform to fit in with those women.
So I think there are distinct, gendered patterns around drinking. And now that’s not to say that all women do this and all men do that. The research sort of suggests these very strict patterns, though.
Kollinger: That’s really helpful. And it brings me to the last portion of our discussion today, which is about how risk managers can assist their student affairs colleagues in helping to manage student alcohol use. How can risk managers help support their colleagues either in student affairs or the across the college in mitigating this risk?
Sasso: I think the first thing is that we need to stop assuming that students come to college not knowing how to drink. That has drastically changed. Students come to college knowing how to drink and are very savvy consumers. These are not the freshman student who drinks out of the keg, and waits in line at a fraternity party anymore, right? They’re not going to drink trashcan punch.
Yes, those are artifacts of the undergraduate experience, but students have experience drinking top-shelf vodka in college. These students are so much more sophisticated and have a wider range of what they drink and have established brands that they associate with themselves on social media. And so, I think undergraduate student culture has drastically changed.
The first thing is recognizing that student culture has changed. And so, our interventions and programs need to change as well. Our shift in thinking needs to start with that student culture has been reconstructed, in ways that are largely linked to social media. Gen Z students often want pictures of themselves having fun at parties, but what’s fascinating is you will not see pictures of them binge drinking, or chugging, or things like that in the same way as you would have millennials.
They don’t want to show themselves being drunk as much. They still do those things, but they’re a little bit, again, more sophisticated – I don’t know about mature, that’s a relative concept. But I think we need to think about the ways in which social media is sort of putting out another culture of alcohol use.
And so, students have a lot more knowledge about alcohol use but they still don’t know how to drink safely. So I think what’s really important is, trying to think about how we reduce harm. Because when we think about this, it’s really about teaching students strategies, or self-strategies, what they call protective behavior interventions. So these are approaches that are based on peer accountability.
And these are proactive social strategies that students construct themselves to reduce self-harm. Like you pay some space, you count your tabs, you stick to one sort of drink, you have to go with friends in a larger group to a party where you don’t know anybody, you actually text to check in if you don’t see each other. So what the research has moved to is teaching students protective behavior interventions (PDIs).
These are ways in which we can reduce harm. And so, and then it’s a larger concept of just alcohol education and trying to build social skills and resetting expectations. During the early 2000s, we had a lot of research on social norming and how we reset student perceptions of their peers’ alcohol use. And so you would see these posters that say, only one in four students drink at XYZ college. That’s moderately effective in reframing the narrative.
And around the time that Facebook got big – 2008, 2009 – and then Instagram sort of took over, social norming kind of stopped. You don’t see a lot of online social norming. And so, that’s one strategy that shows promise that really has not been tested online very well yet. So I think we have opportunities, to reframe what the narrative is.
And so, how do we think about encouraging safer drinking habits that may have been learned during the pandemic, so students who engaged in self-harm, in using alcohol as a form of coping, how do we get those students support that they need? And the other thing that we also need to think about is the return to campus. Marker days might evolve and change. That event-specific drinking might be an opportunity to reset norms. So something like a syllabus week on a lot of campuses is a time in which students heavily drink. That interruption of COVID might be a way to reframe these marker days.
Kollinger: Dr. Sasso, can you please define syllabus week?
Sasso: Oh yeah. So syllabus week is normally a rite of passage on a lot of larger state flagship university campuses, where it’s the first week of classes. So this is where students ... it’s like your back to school week, it’s welcome week. There’s no assignments due. A lot of students colloquially call that syllabus week. And so, that first weekend of classes tends to be a heavy party weekend for a lot of universities.
So how do we think about reconstructing that? How is that a way to reframe or re-story the narrative around things like syllabus week, or gameday drinking around football, around tailgating? Or things like on a lot of campuses, there’s a specific weekend that sororities and fraternities have recruitment events or have initiation events where there tends to be a lot of heavy drinking. How do we reframe that?
COVID is a good chance to reset those expectations. But I think really what it comes down to is trying to build relationships with your students. And that’s challenging when resources are tight.
One of the things that I can end on here that I think we should think about reconstructing, and bringing back, is this idea of peer educators. They were really popular in the ’80s and ’90s and the early 2000s. And they ebb and flow. But I think peer education is a really powerful tool to have connections with your students. And yes, they do programming and workshops for students, but really what it helps risk managers and educators understand is, “What are the current trends on your campus?” It’s so easy to lose touch with what drinking patterns are. But something that’s really important around alcohol use that I think we all understand is that environment shapes what the drinking patterns are.
There are specific nuances that exist on your campus or your school culturally or specific streets or neighborhoods or residence halls that tend to have a reputation for drinking more. And so, campus environment and culture matter. And understanding those is really important to helping you think about how you construct your interventions. And so, peer educators is a way to understand what that culture is, because it’s like a very constant feedback group for you. And it’s a focus group too. And so, it’s a way to get anecdotal evidence about student culture.
Kollinger: I really appreciate the focus on student culture here. And as we think about the different roles that administrators play on campus, a lot of student affairs professionals have a pretty good sense of what the different cultures are on campus. Are there questions that you would encourage a Risk Manager to ask of their student affairs colleagues to help them understand better what some of the best possible avenues are for intervention at the level of a specific targeted group of at-risk students?
Sasso: Yeah. I think it’s about understanding which are the high-risk populations. And I think that’s about assessment. So from a Risk Manager’s perspective, the best way to understand what your profile of students are is to get a snapshot. So using national benchmark surveys, like the [National Institute on Alcohol Abuse and Alcoholism] surveys or the [American College Health Association] surveys, or just there’s a number of national surveys that provides you with a snapshot of what your campus alcohol consumption patterns are. And it also asks other things around alcohol and drugs.
And so, getting that assessment is really important. And that frames a conversation. I think the other thing that’s important to have on most campuses is an alcohol and other drugs task force that brings folks together to think about strategies and ways in which they can engage students, to have conversations around alcohol use.
So I think risk managers should be involved in those conversations, and those committees, and even lead those initiatives as a chair, or lead the larger push to assess. Because most campuses are not going to have a health educator who would do some of that programming.
Kollinger: Are there any other thoughts that we have not had a chance to discuss today, that you think our listeners would find really valuable?
Sasso: I think alcohol use is changing. And we have all of these predictions and we have some early trend data that suggests that it might be increasing. So we’re predicting what we think will be a roaring 20s, but we don’t know that to be true entirely. So this is worst-case scenario. But I think what it does point to is that the ways in which students are drinking is changing and we need more data, we need more assessment, we need to better understand the ways in which Gen Z students consume alcohol.
A lot of our assumptions are based on millennials who drank a lot more. So I don’t think we have a good understanding right now. We just know that students might be starting to drink more and so, therefore, when all these students come back to campus full-time, and COVID recedes, I think that’s what we’re worried about. And I don’t think we have a lot of tools. And so when we’re thinking about what these tools look like, we really need to look at what strategies were effective in the late ‘90s, when we saw this larger uptick. So I think history tells us a lot.
Kollinger: Great. Thank you for the insights, Dr. Sasso. Listeners with an interest in Dr. Sasso’s work can visit www.drsasso.com. In addition, we linked some UE resources from this podcast page on edurisksolutions.org, where UE members can access a wide range of risk management resources. Links to data cited in this podcast can be found there as well.